To Investigate The Assessment Of SOFA Score And RIFLE Classification In The Choosing Treatment Timing Of Continuous Renal Replacement Therapy

OBJECTIVES:To investigate the assessment of sequential organ failure assessment( SOFA) score and RIFLE classification standard in the choosing treatment timing of continuous renal replacement therapy(CRRT)for multiple organ dysfunction syndrome(MODS)with acute kidney injure.METHODS: This was a retrospective single center study,a total of 102 patients of MODS with AKI were enrolled in intensive care unit( ICU) and emergency intensive care unit(EICU),requiring continuous renal replacement therapy from 1January 2012 to 31 December 2013 from the Second Affiliated Hospital of Nanchang University.According to the criteria :Improving Global Outcomes Organization of Kidney Disease of RIFLE classification standard(KDIGO standard)and Sequential Organ Failure Assessment(SOFA)score,the patients were divided into RIFLE 1、2、3groups and SOFA score of≤6、>6groups;ICU survival rate and the recovery rate of renal function、the average ICU days、the medical expenses and the cumulative CRRT dose were compared among groups.RESULTS: Compared with the patients of RIFLE1,2 hospitalized,the patients of SOFA score of≤6 requiring CRRT had significantly higher survival rate [94.6%( 35/37) vs 73.4%( 36/49), P=0.011].The recovery rate of renal function in survivors of SOFA score of≤6 patients was significantly higher than in the RIFLE1,2hospitalized [91.4%(32/35)vs 69.4%(25/36),P=0.02],and the average ICU days,medical expenses,and the cumulative CRRT dose were also significantly reduce [the average ICU days:12.1±5.3 vs 16.1±5.8(P<0.05),the medical expenses(million):2.2±0.9 vs 3.2±1.1( P<0.05), the cumulative CRRT dose( L) 184.4±14.1 vs235.2±27.6(P<0.05)].There was no significant difference in above indexes between this survivors in SOFA score>6 and RIFLE 3 hospitalized(all P>0.05),and these indexes in SOFA score>6 and RIFLE 3 were worse than those patients of SOFA score≤6 and RIFLE 1,2 hospitalized(all P<0.05).CONCLUSIONS: 1、In early stage of Acute Kidney Injure,the initial time tostart CRRT can improve patients,outcome obviously; 2 、 In patients of MODS accompanied by AKI,compared with the patients of RIFLE1,2 as initial time to start CRRT,those patients of SOFA score ≤6 may not only improve survival rate and the recovery of renal function,but also may reduce the ICU stay days 、the medical expenses and the cumulative CRRT dose.